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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Anemia is one of the most common complications in chronic kidney disease &#40;CKD&#41;&#44; being more prevalent as the disease progresses&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The causes of anemia associated with CKD are diverse&#46; Classically&#44; an inadequate production of endogenous erythropoietin was recognized as the main cause&#46; However&#44; in recent years other contributing factors have been recognized&#44; such as decreased bone marrow erythropoietic response&#44; absolute or functional iron deficiency and shortened red blood cell lifespan&#44; among others&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> Anemia in CKD leads to reduced quality of life&#44; increased risk of cardiovascular disease and progression to end-stage CKD&#44; increased hospitalization and mortality rates&#44; as well as cognitive impairment&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">CKD has an overall prevalence that is ranging between 11 and 13&#37;&#44; with the majority of patients at stage 3&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a> In Spain&#44; the EPIRCE &#40;2010&#41;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> and ENRICA &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> studies have evaluated this prevalence&#44; denoting its increase over time in our country&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">With respect to anemia&#44; although there are studies in Spain that analyze its prevalence in CKD&#44; there are limitations in the available data&#46; These publications are old or are limited to a specific population of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;17</span></a> The MERENA study &#40;2011&#41; estimated this comorbidity in CKD stages 3 and 4 &#40;43&#46;7&#37; and 58&#46;1&#37;&#44; respectively&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The NADIR study &#40;2013&#41; analyzed the incidence of anemia in patients with CKD stage3 &#40;35&#37; in 36 months&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;15</span></a> Shortly thereafter&#44; the MICENAS study &#40;2014&#41; evaluated the prevalence of anemia &#40;58&#46;5&#37;&#41; and its clinical management in patients with CKD stages 3&#8211;5&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> In 2017&#44; Guerrero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> estimated the prevalence in patients with CKD stage 3a-5 and older than 90 years at 35&#46;7&#37;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this context&#44; iron therapy and erythropoiesis-stimulating agents &#40;ESA&#41; have been widely used&#44; especially in combination&#44; for the treatment of renal anemia&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; the use of iron for the treatment of renal anemia is not optimal&#44; as iron parameters are not adequately corrected&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Furthermore&#44; the literature on epidemiology and treatment of anemia in Spain is not recent and it is limited&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;17</span></a> The aim of the present study was to evaluate the prevalence and incidence of anemia in CKD&#44; as well as to characterize the subpopulation with anemia and its management in real clinical practice in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design</span><p id="par0025" class="elsevierStylePara elsevierViewall">Two types of populations were defined&#46; The population with incident CKD were those that began the disease at inclusion in the study &#40;in this individuals there were no CKD records during the year preceding inclusion&#41;&#46; The prevalent population already had CKD on January 1&#44; 2015&#44; January 1&#44; 2016&#44; and January 1&#44; 2017&#46; To estimate the incidence of these outcomes&#44; dynamic cohorts were constructed&#46; This allowed patients to enter and&#47;or exit a cohort during half of the study period&#46; Similarly&#44; patients with incident anemia were so at the time of inclusion in the study &#40;did not have anemia during the preceding year&#41;&#46; Patients with prevalent anemia were already anemic as of January 1&#44; 2015&#46; Incident anemic patients treated with ESAs were those who received the first prescription during the year of inclusion in the study &#40;no precedent of treatment in the previous year&#41;&#46; In this case&#44; prevalent patients were those whose first prescription occurred before January 1&#44; 2015&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">These estimates were standardized by age and sex with respect to the population of Spain&#46; Patients in the cohort of interest were indexed as of January 1 of each year if they had a history of diagnosis&#47;treatment or at the first diagnosis&#47;treatment occurring in that year&#46; Patients who had a history of the event before the indexing date were excluded from the calculation in order to create a cohort of patients at risk&#46; Patients in the cohort were followed from their index date to the first event date in the database&#44; 12 months after indexing&#44; death&#44; transplantation&#44; dialysis &#40;non-dialysis CKD &#91;ND-CKD&#93; cohorts only&#41;&#44; or last observation &#40;whichever occurred first&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Patient inclusion criteria included&#58; subjects older than 18 years with ND-CKD in stages 3a-5 or CKD in dialysis program &#40;D-CKD&#41;&#44; at any time during the study period &#40;from January 1&#44; 2015 to December 31&#44; 2017&#41;&#46; In order to be part of the prevalent cohorts &#40;belonging to the years 2015&#44; 2016&#44; 2017&#41; patients had to meet the inclusion criteria &#40;2015&#8211;2017&#41;&#44; and have no prior evidence of cancer &#40;or be on chemotherapy treatment&#41; before the indexing date&#46; Additionally&#44; patients could not be permanently institutionalized during 2015&#8211;2017&#44; nor have received a transplant or have iron deficiency anemia at any point prior to indexing&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data collection and variables evaluated</span><p id="par0040" class="elsevierStylePara elsevierViewall">The data were extracted from anonymized medical reports in Spain included in the BIG-PAC database&#174;&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> which contains anonymized data of 1&#46;9 million patients in the country&#44; from seven autonomous communities&#46; It has been shown that the use of this database is acceptable in terms of representativeness of the population&#44; so that the results can be projected directly onto the whole&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Data were extracted&#44; and patients were followed up using a unique administrative identifier&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The primary objective was to estimate the incidence and prevalence of anemia associated with ND-CKD &#40;3a-5&#41; and D-CKD in the general population for the years 2015&#44; 2016 and 2017&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The secondary objectives were&#58; to describe the prevalence and incidence of CKD in the general population&#44; as well as the prevalence and incidence of anemia in patients diagnosed with CKD and of treatment with erythropoiesis-stimulating agents &#40;ESA&#41; in anemic patients with CKD&#59; to describe clinical and demographic characteristics&#59; to describe treatment patterns for anemia associated with CKD&#44; and in particular in patients treated with ESA&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Regarding clinical and demographic characteristics&#44; the presence or absence of the following comorbidities were collected&#44; presented together with their <span class="elsevierStyleItalic">International Classification of Diseases</span> &#40;ICD&#41; code&#58; history of arterial hypertension &#40;ICD-10&#58; I10-15&#41;&#44; rheumatoid arthritis &#40;ICD-10&#58; M05-M06&#41;&#44; type 2 diabetes mellitus &#40;ICD-10&#58; M06&#41;&#44; dyslipidemia &#40;ICD-10&#58; E78&#41;&#44; obesity &#40;ICD-10&#58; E66&#41;&#44; cardiovascular disease &#40;ischemic heart disease&#41; &#91;ICD-10&#58; I20&#93;&#44; acute myocardial infarction &#91;ICD-10&#58; I21-22&#93;&#44; cerebrovascular accident &#91;ICD-10&#58; I61-I64&#93;&#44; stroke &#91;ICD-10&#58; I63&#93;&#44; peripheral arterial disease &#91;ICD-10&#58; I73&#46;9&#93;&#44; heart failure &#91;ICD-10&#58; I50&#93;&#41;&#44; depression &#40;ICD-10&#58; F34&#46;1&#41;&#44; chronic obstructive pulmonary disease &#40;ICD-10&#58; J41-42&#44; J44&#41;&#44; and osteoporosis &#40;ICD-10&#58; M80-82&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Concerning the variables analyzed&#44; the patient was considered to be anemic if there was a diagnosis and&#47;or at least two consecutive measurements of hemoglobin &#40;Hb&#41; &#60;13&#160;g&#47;dl &#40;8&#46;1&#160;mmol&#47;l&#41; for men and &#60;12&#160;g&#47;dl &#40;7&#46;5&#160;mmol&#47;l&#41; for women according to the KDIGO guidelines&#44; and&#47;or at least two treatments for anemia &#40;e&#46;g&#46;&#44; intravenous iron and&#47;or ESA&#41;&#46; Patients were classified into the different CKD stages according to the KDIGO guidelines using the estimated glomerular filtration rate &#40;eGFR&#41; value&#58; 3a &#40;45&#8722;59&#160;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#44; 3b &#40;30&#8722;44&#160;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#44; 4 &#40;15&#8722;29&#160;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#44; 5 &#40;&#60;15&#160;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#46; The erythropoietin resistance index &#40;ERI&#41; was calculated as the weekly ESA dose in relation to patient weight and hemoglobin levels &#40;weekly ESA dose &#47;weight &#40;kg&#41; &#47;Hb &#91;g&#47;dl&#93;&#41;&#46; To homogenize information on ESA doses&#44; there were conversion factors used to express doses in international units &#40;IU&#41;&#46; If the patient received weekly darbepoetin&#44; this value was multiplied by 200&#46; In the case of biweekly doses&#44; first the value was divided by two to obtain the dose&#47;week and then the correction factor was applied&#46; If the patient was treated with methoxypolyethylene glycol &#40;MPG&#41;-epoetin beta&#44; the monthly dose was divided by four &#40;dose&#47;week value&#41; and the result was multiplied by 250&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Baseline characteristics refer to the 12 month history of each patient in each cohort&#46; Each identified characteristic was analyzed and presented in tables of descriptive statistics&#44; means&#44; standard deviation &#40;SD&#41; and percentages for categorical variables&#46; Qualitative variables are shown as absolute and relative frequencies&#44; while quantitative variables are expressed as mean and standard deviation&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Prevalence and incidence</span><p id="par0070" class="elsevierStylePara elsevierViewall">The prevalence and incidence of CKD in the general population in the different cohorts during 2015&#44; 2016 and 2017 are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The prevalence and incidence of renal anemia in the general population were&#44; respectively&#44; 1&#46;6&#37; and 0&#46;4&#37; for ND-CKD and 0&#46;03&#37; and 0&#46;001&#37; for D-CKD&#46; These values remained stable throughout the period analyzed&#46; The prevalence and incidence of anemia in the ND-CKD population remained stable&#58; &#40;&#8764;34 and 10&#46;9&#37;&#44; respectively&#41;&#46; The prevalence of anemia increased as renal function worsened&#44; being 71&#46;8&#8211;73&#46;4&#37; in ND-CKD stage 5 patients&#46; In the case of D-CKD the prevalence was stable &#40;&#8764;91&#37;&#41;&#44; with an incidence ranging 56&#46;4&#8211;69&#46;7 &#37; depending on the year considered&#46; During the study period&#44; the prevalence in hemodialysis &#40;HD&#41; patients remained stable &#40;&#8764;95&#46;5&#37;&#41;&#44; with an incidence of 61&#46;6&#8211;70&#46;5&#37; depending on the year considered&#46; In peritoneal dialysis &#40;PD&#41; the prevalence was &#8764;83&#37;&#44; with an increasing incidence&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The prevalence of anemic patients with ND-CKD treated with ESAs remained around 26&#37;&#44; with an incidence of &#8764;8&#37;&#46; The use of ESA increased with the severity of CKD in the range of 15&#46;7&#8211;18&#46;1&#37; in stage 3a&#44; and up to 54&#46;3&#8211;61&#46;9&#37; in stage 5&#46; In patients with D-CKD the prevalence remained around 85&#37;&#44; with an incidence was close to 61&#37;&#46; For both parameters&#44; the percentage in patients in HD was higher than in PD&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Demographic and clinical characteristics of patients</span><p id="par0085" class="elsevierStylePara elsevierViewall">Demographic and clinical characteristics of the patients are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The mean age of anemic patients with ND-CKD and D-CKD was 78&#46;0 and 68&#46;2 years&#44; respectively&#46; In the anemic population on ESA treatment the mean age was 73&#46;3 and 65&#46;4 years&#46; Overall&#44; the percentage of males was higher than females in each cohort&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">All cohorts presented a Charlson comorbidity index around 4&#46; The most prevalent comorbidities were arterial hypertension&#44; dyslipidemia&#44; diabetes mellitus&#44; and cardiovascular disease in varying proportions&#46; Consistent with these pathologies&#44; the most commonly used medications in all cohorts were antihypertensive agents&#44; diuretics&#44; lipid-lowering agents&#44; antidiabetics&#44; and vitamin D&#46; Regarding the cause of renal disease&#44; the most prevalent was hypertensive and vascular disease &#40;range&#58; 40&#46;9&#8211;49&#46;6 &#37;&#41;&#44; followed by diabetes mellitus &#40;range&#58; 20&#46;5&#8211;25&#46;8&#37;&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mean ferritin and transferrin saturation index &#40;TSAT&#41; levels in the ND-CKD populations were 172&#46;8&#160;ng&#47;mL and 24&#46;8&#37;&#44; respectively&#46; The data for the subgroup with D-CKD were 241&#46;3&#160;ng&#47;mL and 22&#46;0&#37;&#46; In anemic ND-CKD patients&#44; the values were 187&#46;3&#160;ng&#47;mL and 21&#46;8&#37;&#44; respectively&#46; The mean baseline ferritin and TSAT level for anemic patients with D-CKD was 256&#46;0&#160;ng&#47;mL and 19&#46;9&#37;&#46; Under ESA treatment&#44; the data were 198&#46;3&#160;ng&#47;mL and 20&#46;7&#37; for ND-CKD and 268&#46;6&#160;ng&#47;mL and 19&#46;5&#37; for D-CKD&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The prevalence of inflammation &#40;defined by C-reactive protein levels higher than 5&#160;mg&#47;l&#41; in the population with ND-CKD and D-CKD was 9&#46;9&#37; and 55&#46;5&#37;&#44; respectively &#40;year 2015&#41;&#46; In the group with anemia&#44; the values remained stable during the study period &#40;&#8764;18&#37; and &#8764;54&#37;&#44; respectively&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The prevalence in anemic patients treated with ESA was &#8764;29&#37; and &#8764;48&#37;&#44; respectively&#46; In ND-CKD patients the prevalence of inflammation was higher in anemic patients &#40;being even more prominent if they were on ESAs&#41; versus the general ND-CKD population&#46; In addition&#44; D-CKD patients&#44; regardless of anemic status or ESA treatment&#44; had a higher prevalence of inflammation than those with ND-CKD&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Treatments for anemia</span><p id="par0105" class="elsevierStylePara elsevierViewall">The treatments for the prevalent population followed throughout 2015 for 12 months is shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; with additional information on patients treated with ESA presented in Appendix Supplementary Appendix A&#44; Table 1&#46; Anemic patients with ND-CKD and D-CKD were treated with oral iron &#40;58&#46;5&#37; and 3&#46;5&#37;&#44; respectively&#41;&#44; intravenous iron &#40;1&#46;8&#37; and 6&#46;0&#37;&#41;&#44; ESA with oral iron &#40;10&#46;7&#37; and 7&#46;9&#37;&#41;&#44; or ESA with intravenous iron &#40;3&#46;4&#37; and 62&#46;9&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">In the group of patients treated with ESAs&#44; recombinant human erythropoietin &#40;rHuEPO&#41; was the most commonly used in both subgroups &#40;46&#46;6&#37; and 46&#46;2&#37; for ND-CKD and D-CKD&#44; respectively&#41;&#44; followed by darbepoetin alfa &#40;30&#46;1&#37; and 30&#46;0&#37;&#41; and methoxypolyethylene glycol &#40;MPG&#41;-epoetin beta &#40;23&#46;4&#37; and 23&#46;8&#37;&#59; Appendix A&#44; Supplementary Table 2&#41;&#46; The doses used are detailed in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> and the mean is shown in Appendix A Supplementary Table 3&#46; The patterns of ESA treatment in anemic patients with ND-CKD &#40;3a-5&#41; and D-CKD are shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; The majority of patients maintained the initial treatment and very few were changed to a second or third line of treatment&#46; In patients treated with ESA the mean ERI was 4&#46;8 and 5&#46;5 IU week&#47;kg&#47;g Hb in dl&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Results of hemoglobin and iron parameters of anemia treatment at 12 months of follow-up&#46;</span></p><p id="par0120" class="elsevierStylePara elsevierViewall">These data are detailed in <a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#46; At 12 months of follow-up&#44; the mean values of ferritin and TSAT in patients with ND-CKD were 187&#46;1&#160;ng&#47;mL and 22&#46;2&#37;&#44; respectively&#46; In patients with D-CKD were 254&#46;6&#160;ng&#47;mL and 20&#46;2&#37;&#46; In ESA-treated patients&#44; mean ferritin and TSAT values were 190&#46;6&#160;ng&#47;mL and 22&#46;0&#37; in ND-CKDR&#44; and 255&#46;0&#160;ng&#47;mL and 20&#46;2&#37; in those with D-CKD&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Achieving and maintaining target hemoglobin levels</span><p id="par0125" class="elsevierStylePara elsevierViewall">This section presents the data of anemic patients treated with ESA &#40;alone or in combination&#41; relative to the maintenance of target hemoglobin levels&#46; The description of these patients according to stage and concomitant treatment is shown in <a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a>&#44; the data is obtained in stable patients &#40;those who maintained Hb levels at 10&#8722;12&#160;g&#47;dl throughout follow-up&#41;&#44; patients with unstable Hb &#40;at least one Hb value &#60; 10&#160;g&#47;dl and at least one value &#62; 12&#160;g&#47;dl during the 12 months of follow-up&#41; and patients with occasional increases or decreses &#40;all Hb values &#60; 12&#160;g&#47;dl and at least one value &#60; 10&#160;g&#47;dl &#91;decrease&#93; or all values &#62; 10&#160;g&#47;dl and at least one value &#62; 12&#160;g&#47;dl &#91;increase&#93;&#41;&#46; Among patients with ND-CKD&#44; approximately 10&#37; always maintained target hemoglobin levels&#44; with variations depending on treatment &#40;8&#46;6&#37; for ESA&#44; 8&#46;1&#37; for combination of oral iron and ESA&#44; 6&#46;7&#37; for intravenous iron and ESA&#44; 11&#46;1&#37; for combination of oral&#44; intravenous iron and ESA&#41;&#46; In this same subgroup&#44; about 50&#37; maintained target levels most of the time &#40;but with occasional increases or decreases&#41; and about 40&#37; had significant fluctuations in Hb levels&#46; Among patients with D-CKD less than 5&#37; maintained target levels &#40;4&#46;8&#37; for ESA treatment&#44; 0&#46;0&#37; for oral iron and ESA&#44; 1&#46;7&#37; for intravenous iron and ESA&#44; 0&#46;0&#37; for the combination oral iron&#44; intravenous iron and ESA&#41;&#46; Approximately 60&#37; experienced Hb oscillations both &#60; 10&#160;g&#47;dl and &#62; 12&#160;g&#47;dl&#46;</p><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Transfusions in patients with anemia</span><p id="par0130" class="elsevierStylePara elsevierViewall">Detailed data regarding transfusions in patients with anemia associated with CKD is shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; Regardless of treatment&#44; 9&#46;1&#37; and 53&#46;3&#37; of patients with ND-CKD and D-CKD received at least one transfusion&#46; A high frequency of blood transfusions was observed in anemic patients in both the ND-CKD and D-CKD groups&#44; however it is not known whether these transfusions were due to renal anemia or to other causes&#44; such as surgery or acute hemorrhage&#46; The percentage of patients who received at least one blood transfusion increased with the severity of the disease&#44; coinciding with an increasing number of hospitalizations as the renal disease worsened&#44; and especially in dialysis&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">This population-based study analyzed the prevalence and incidence of anemia&#44; as well as its treatment&#44; in the Spanish population&#46; In the RIKAS study&#44; the prevalence of ND-CKD stages 3&#8211;5 was somewhat lower than in previous studies&#44; although similar in number and distribution to that of the EPIRCE study&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Other studies analyzed the prevalence of anemia in CKD in Spain&#46; However&#44; these studies are not recent or focus only on certain subgroups of patients&#46; In addition&#44; the definition of anemia is not consistent among the different studies&#44; or it is not specified&#44; and most of them analyze patients attended in outpatient nephrology clinics&#44; unlike this population-based study&#46; Thus&#44; in the MICENAS study&#44; the prevalence of anemia in ND-CKD stage 3&#8211;5 patients in Catalonia was 58&#46;5&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> In general&#44; as the disease progressed&#44; mean hemoglobin levels decreased and ESA use was increased&#46; However&#44; there was no change in the prescription of Iron according to stage&#46; In this study&#44; more than half of the patients were able to correct their anemia with iron supplementation combined with moderate doses of ESA&#46; In the MERENA multicenter observational study of patients with ND-CKD stages 3 and 4&#44; 43&#46;7&#37; and 58&#46;1&#37;&#44; respectively&#44; were anemic&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> of which 16&#37; and 34&#46;1&#37; of the patients received ESA treatment&#44; respectively&#46; Guerrero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> conducted a prospective study in a center in Huesca in 288 patients over 90 years of age&#44; obtaining a prevalence of anemia of 35&#46;7&#37; in stages 3a-5&#46; The results regarding the prevalence of anemia in CKD patients in our study were consistent with previous studies in Spain&#44; although its prevalence was somewhat lower&#46; In this context&#44; it is important to highlight the population base of our study&#46; At international level&#44; this prevalence was higher than that found in the population-based study by Stauffer and Fan&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> based on data from the <span class="elsevierStyleItalic">National Health and Nutrition Examination Survey</span> &#40;NHANES&#41; of the United States&#44; and it was similar to that recently published using the Swedish registry of renal patients&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Overall&#44; prevalence increased with CKD stage in ND-CKD patients&#44; as shown in previous studies&#46; Anemia was more prevalent among men than women&#44; consistent with previous studies&#46; The demographic data of the RIKAS study population is also consistent with previous analyses&#46; In addition&#44; the most common comorbidities were hypertension&#44; dyslipidemia&#44; diabetes mellitus&#44; and cardiovascular disease&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Regarding data on the incidence of renal anemia in Spain&#44; the single study in the literature is the NADIR study&#44; which evaluated the incidence of anemia in patients with ND-CKD stage 3 in a prospective analysis over 3&#160;years&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;15</span></a> During the first year of the study&#44; up to 12&#46;4&#37; of subjects were diagnosed with anemia&#46; Over the 3&#160;year follow-up&#44; half of the patients progressed to stages 4&#8211;5&#44; and about 35&#37; were diagnosed with anemia &#40;mostly of renal origin&#41;&#46; A significant association was found between the development of anemia and baseline hemoglobin levels&#44; eGFR&#44; and the sex of the patients&#46; In addition&#44; the development of anemia was associated with a more rapid progression of the disease and a higher risk of having a major cardiovascular event&#46; This incidence was slightly higher than the one found in our study for that subgroup of patients &#40;&#8764;7 to 10&#37;&#41;&#46; However&#44; our study analyzed the incidence of anemia and ESA treatment in all groups of ND-CKD &#40;3a-5&#41; and D-CKD&#44; and it is a population-based study and not of patients followed in nephrology outpatient clinics&#46; Up to &#8764;8&#37; and &#8764;61&#37; of the ND-CKD and D-CKD population initiated ESA treatment during the study period&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">An interesting finding of the present study was that anemic patients with ND-CKD had a higher prevalence of inflammation than those without anemia &#40;&#8764;18&#37; vs&#46; &#8764;10&#37;&#41;&#46; Among them&#44; ESA-treated patients were the cohort with the highest prevalence of inflammation &#40;&#8764;29&#37;&#41;&#46; Although this could be due&#44; in part&#44; to a worse renal function in anemic patients &#40;treated or not with ESA&#41;&#44; as the prevalence of anemia and ESA treatment increased with more advanced stages of the disease&#46; In addition&#44; in the subgroup of patients with D-CKD&#44; all subgroups showed a high prevalence of inflammation &#40;approximately 50&#37;&#41;&#46; These values are lower than the reported in the Swedish study on ND-CKD subgroup&#44; but similar to the D-CKD group&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Inflammation has been associated with a hyporesponsiveness to ESA and the consequent need for higher doses of ESA&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Regarding treatment&#44; the KDIGO guidelines recommend iron supplementation if the TSAT is &#60; 30&#37; and serum ferritin &#60; 500&#160;ng&#47;mL&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> However&#44; the <span class="elsevierStyleItalic">European Renal Best Practice</span> &#40;ERBP&#41; guideline recommends supplementation if there is absolute iron deficiency &#40;TSAT&#160;&#60;&#160;20&#37; and ferritin &#60; 100&#160;ng&#47;mL in ND-CKD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> There is also a recommendation to start iron treatment if there is a desire to increase Hb levels without ESA and ferritin levels are &#60; 200 &#956; g&#47;l &#40;ferritin &#60; 300 &#956; g&#47;l if patient is in dialysis&#41; and TSAT&#160;&#60;&#160;25&#37; or reduce ESA doses if ferritin &#60; 300 &#956; g&#47;l and TSAT&#160;&#60;&#160;30&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> In our study the mean ferritin and TSAT values were lower than recommended in the guidelines&#44; suggesting an underutilization of iron therapy in this anemic population with CKD in both non-dialysis and dialysis&#46; Consequently&#44; there is an opportunity for improvement to optimize the management of renal anemia&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In order to treat anemia&#44; iron was given to 74&#46;7&#37; of anemic patients with ND-CKD &#40;69&#46;4&#37; oral and 5&#46;2&#37; intravenous&#41; and 81&#46;9&#37; of anemic patients with D-CKD &#40;13&#37; oral and 68&#46;9&#37; intravenous&#41; and 33&#46;8&#37; of anemic patients with ND-CKD and 88&#46;9&#37; of anemic patients with D-CKD received ESA&#46; It should be noted that it is not known whether the patients could have received intravenous iron for causes other than renal anemia&#44; such as heart failure&#46; Nevertheless&#44; the data collected was the use of intravenous iron in patients with anemia associated with CKD&#44; so it seems reasonable that it was used mainly for the correction of anemia&#46; As in previous studies&#44; patients with ND-CKD mostly received oral iron&#44; as advised by the ERBP or <span class="elsevierStyleItalic">National Institute for Health and Care Excellence</span> &#40;NICE&#41; guidelines&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;28</span></a> However&#44; there is no data available on dose or compliance&#44; but analyzing the mean ferritin and TSAT levels achieved&#44; patients would probably benefit from a greater use of intravenous Iron&#44; despite its greater use in stages 4 and 5&#46; Iron therapy was similarly across all stages of ND-CKD&#44; in line with what was observed in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;22</span></a> Several clinical studies and a meta-analysis in patients with ND-CKD have shown that intravenous Iron is safe&#44; and more effective and faster than oral iron in achieving the increase Hb levels and the reduction of ESA doses&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> In dialysis patients&#44; especially on HD&#44; most received intravenous iron&#44; as advised by guidelines&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">ESA use increased with the severity of the disease&#44; as did the requirement for higher doses&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; The ERI was lower in ND-CKD patients&#44; and tended to increase with the disease severity&#44; being higher in hemodialysis patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; These data is similar to the obtained in the Swedish study by Evans et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">Hemoglobin variability is common in this population&#44; especially in those treated with ESA&#44; and in some&#44; but not all studies&#44; it has been associated with worse quality of life&#44; increase in hospitalizations&#44; morbidities and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In the present study&#44; a minority of anemic patients with CKD successfully maintained target Hb levels in the 10&#8722;12&#160;g&#47;dl range during the follow-up&#46; Among the different subgroups&#44; HD patients had the highest rates of variability&#44; a fact that coincides with a Spanish retrospective study in dialysis patients&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">On the other hand&#44; the need for transfusions was relatively high in our study &#40;especially in D-CKD&#41;&#44; despite the fact that the guidelines recommend a restrictive use of transfusions&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Although the reasons are unknown&#44; presumably the patients could have received transfusions for reasons other than anemia associated with CKD&#46; In this regard&#44; a higher rate of hospitalizations was observed according to the severity of renal dysfunction and was higher in patients on dialysis&#46; In general&#44; the more acute events requiring hospitalization&#44; the higher the risk of transfusions&#46; In this context&#44; it should be remembered that transfusions should be avoided due to the intrinsic risks&#44; especially in patients who are candidates for renal transplantation&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The absence of randomization is an intrinsic limitation of the design&#44; as it produces a selection bias in observational studies&#44; and also allows to describe associations but we cannot infer acausal relationship&#46; In addition&#44; treatment was assessed on the basis of prescriptions&#44; with no information available about adherence&#46; Patients could be participating in a clinical trial and&#44; therefore&#44; the treatment pattern would not be a true reflection of normal patterns&#44; although it is not expected to significantly influence the results&#46; In addition&#44; the database from the different geographic areas of Spain are not distinguishable&#46; The number of transfusions was high in ND-CKD stage 5 and D-CKD patients&#59; however&#44; the database does not capture the reasons for transfusions&#44; which might not be directly related to CKD&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Among the strengths of the study is the large sample used&#44; which is representative of the Spanish population&#46; In addition&#44; currently&#44; data have been used to calculate prevalence and incidence&#44; in a scenario in which previous publications did not capture the reality of the pathology&#46; Another relevant point is that it has been analyzed the anemia associated with ND-CKD &#40;3a-5&#41; and D-CKD instead of focusing on a single subgroup of patients&#44; thus providing a global view of the disease and its progression&#46; Also&#44; It is important to add that our study adds the treatments that patients are following&#44; which allows us to analyze the real clinical practice in Spain&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0190" class="elsevierStylePara elsevierViewall">The RIKAS study provides a recent epidemiological assessment of anemia in ND-CKD &#40;stages 3a-5&#41; and D-CKD &#40;HD&#44; PD&#41; in Spain during 2015&#8722;2017&#46; The prevalence of anemia and that of inflammation vary according to the disease severity&#46; Finally&#44; although anemic patients receive oral or intravenous iron therapy&#44; associated or not with ESA&#44; in the long term these treatments are insufficient to achieve the optimal values of iron parameters recommended by the guidelines&#46; Consequently&#44; there is a broad room for improvement in optimizing treatment in patients with anemia associated with CKD&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Ethical considerations</span><p id="par0195" class="elsevierStylePara elsevierViewall">This study was approved by the Ethics Committee of the Consorci Sanitari de Terrassa&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financing</span><p id="par0200" class="elsevierStylePara elsevierViewall">This study was sponsored by <span class="elsevierStyleGrantSponsor" id="gs0005">Astellas Pharma Inc&#46;</span> Medical writing support was provided by Sonia Romero Perez&#44; PhD&#44; of Meisys-Mediaci&#243;n Cient&#237;fica S&#46;L&#46;&#44; funded by Astellas Pharma S&#46;A&#46; Permission for this acknowledgement was obtained and has been included in the final version of the manuscript&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflict of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">Aleix Cases reports receiving a grant&#44; consulting and speaking fees from Vifor Pharma&#44; speaking and consulting fees from Astellas&#44; AstraZeneca and Novo Nordisk&#59; consulting fees from GSK and Otsuka and speaking fees from Amgen and Bayer&#46; Elena Gonz&#225;lez de Antona S&#225;nchez and Giovanna Cadeddu are employees of Astellas Pharma S&#46;A&#46; Maria Mata Lorenzo is an employee of Astellas Pharma Europe Ltd&#46;</p></span></span>"
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              "titulo" => "Achieving and maintaining target hemoglobin levels"
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            0 => "Chronic kidney disease &#40;CKD&#41;"
            1 => "Anaemia"
            2 => "CKD on dialysis"
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            5 => "Erythropoiesis-stimulating agents"
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            0 => "Enfermedad renal cr&#243;nica &#40;ERC&#41;"
            1 => "Anemia"
            2 => "ERC en di&#225;lisis"
            3 => "ERC no en di&#225;lisis"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Studies on the prevalence of anaemia in chronic kidney disease in adults not on dialysis &#40;CKD-ND&#41; and in dialysis programmes &#40;CKD-D&#41; in Spain are not recent or focus on certain subgroups&#46; The aim of this study was to know the epidemiology and current treatment patterns of anaemia associated with CKD in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Multicentre&#44; non-interventional&#44; retrospective study with CKD-ND stage 3a-5 and CKD-D patients treated in Spain between 2015 and 2017 &#40;RIKAS study&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">The prevalence of anaemia in CKD-ND and CKD-D in 2015 was 33&#46;8&#37; and 91&#46;5&#37;&#44; respectively&#44; with similar results during 2016&#8722;2017&#46; The prevalence of systemic inflammation in anaemic patients &#40;18&#46;1&#37; and 51&#46;8&#37; for CKD-ND and CKD-D&#44; respectively&#41; was higher&#44; especially in those treated with erythropoiesis-stimulating agents &#40;ESA&#41;&#44; compared to the general population with CKD-ND&#46; After 12 months of follow-up&#44; mean ferritin and transferrin saturation index &#40;TSI&#41; values in anaemic patients with CKD-ND were 187&#46;1&#160;ng&#47;mL and 22&#46;2&#37;&#44; respectively&#44; while in CKD-D were 254&#46;6&#160;ng&#47;mL and 20&#46;2&#37;&#46; In ESA-treated patients&#44; mean values were 190&#46;6&#160;ng&#47;mL and 22&#46;0&#37; in ND-CKD&#44; and 255&#46;0&#160;ng&#47;mL and 20&#46;2&#37; in D-CKD&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">The prevalence of anaemia and inflammation increased with the disease severity&#44; being higher in D-CKD&#46; Iron parameters in anaemic patients treated or not with ESA are insufficient according to the guidelines&#44; so there is room for improvement in the treatment of anaemia associated with CKD&#46;</p></span>"
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            "titulo" => "Background and objective"
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            "titulo" => "Materials and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivo</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Los estudios sobre la prevalencia de anemia en enfermedad renal cr&#243;nica en adultos no en di&#225;lisis &#40;ERC-ND&#41; y en programa de di&#225;lisis &#40;ERC-D&#41; en Espa&#241;a no son recientes&#44; o se centran en ciertos subgrupos&#46; El objetivo fue conocer la epidemiolog&#237;a y patrones actuales de tratamiento de la anemia asociada ala ERC en Espa&#241;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Estudio multic&#233;ntrico&#44; no intervencionista&#44; retrospectivo con pacientes ERC-ND estadios 3a-5 y ERC-D&#44; atendidos en Espa&#241;a entre 2015 y 2017 &#40;estudio RIKAS&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia en ERC-ND y ERC-D en 2015 fue 33&#44;8&#37; y 91&#44;5&#37;&#44; respectivamente&#44; con resultados similares durante 2016&#8722;2017&#46; La prevalencia de inflamaci&#243;n sist&#233;mica en pacientes an&#233;micos &#40;18&#44;1&#37; y 51&#44;8&#37; para ERC-ND y ERC-D&#44; respectivamente&#41; fue superior&#44; especialmente en aquellos tratados con agentes estimuladores de eritropoyesis &#40;AEE&#41;&#44; respecto a la poblaci&#243;n general con ERC-ND&#46; Tras 12 meses de seguimiento&#44; los valores medios de ferritina e &#237;ndice de saturaci&#243;n de transferrina &#40;IST&#41; en pacientes an&#233;micos con ERC-ND fueron 187&#44;1&#160;ng&#47;mL y 22&#44;2&#37;&#44; respectivamente&#59; mientras que en ERC-D fueron 254&#44;6&#160;ng&#47;mL y 20&#44;2&#37;&#46; En pacientes tratados con AEE&#44; los valores medios fueron 190&#44;6&#160;ng&#47;mL y 22&#44;0&#37; en ERC-ND&#44; y 255&#44;0&#160;ng&#47;mL y 20&#44;2&#37; en ERC-D&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de anemia e inflamaci&#243;n aumentan con la severidad de la enfermedad&#44; siendo mayores en ERC-D&#46; Los par&#225;metros f&#233;rricos en pacientes an&#233;micos tratados o no con AEE son insuficientes seg&#250;n las gu&#237;as&#44; por lo que existe un margen de mejora para el tratamiento de la anemia asociada a la ERC&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dose of ESA used in anemic patients with CKD&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">ESA&#58; erythropoiesis-stimulating agents&#59; CKD&#58; chronic kidney disease&#59; D&#58; on dialysis&#59; ND&#58; not on dialysis&#59; IU&#58; international units&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Lines of treatment in anemic patients treated with ESAs with &#40;a&#41; ND-CKD &#40;3a-5&#41;&#44; and &#40;b&#41; D-CKD&#46;</p>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ESA&#58; erythropoiesis-stimulating agents&#59; CKD&#58; chronic kidney disease&#59; ND&#58; not on dialysis&#59; D&#58; on dialysis&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anemia of CKD in the general population&#46;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CKD in the general population &#40;&#37;&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anemia in the CKD population &#40;&#37;&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anemic patients with CKD treated with ESA &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Prevalence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Incidence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Incidence</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Incidence</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Date&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD&#40;3a-5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">81&#46;9&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; CKD&#44; chronic kidney disease&#59; ESA&#44; erythropoiesis-stimulating agents&#59; CRP&#44; C-reactive protein&#59; NA&#44; not applicable&#59; SD&#44; standard deviation&#59; ND&#44; not on dialysis&#59; D&#44; on dialysis&#59; SD&#44; standard deviation&#46;</p>"
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CKD patients with anemia</th><th class="td-with-role" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKDn&#160;&#61;&#160;37&#44;664&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKDn&#160;&#61;&#160;326&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKDn&#160;&#61;&#160;280&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKDn&#160;&#61;&#160;252&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;years&#41;&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78&#46;2 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;929 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">68 &#40;24&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;347 &#40;40&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">91 &#40;36&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Men&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21&#44;417 &#40;56&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">227 &#40;74&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">CR</span><span class="elsevierStyleItalic">P</span><span class="elsevierStyleItalic">&#62;5&#160;mg&#47;l</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">983 &#40;29&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">BMI&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Charlson comorbidity index&#44; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyslipidemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">121 &#40;48&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiovascular disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">237 &#40;84&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">201 &#40;79&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cause of CKD&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertensive and vascular renal disease&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&#44;445 &#40;41&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">125 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;218 &#40;41&#46;&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">115 &#40;41&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">125 &#40;49&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetic kidney disease&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#44;901 &#40;21&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">837 &#40;24&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomerulopathies&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Current medication&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antihypertensives&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diuretics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lipid-lowering agents&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antidiabetics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vitamin D&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">154 &#40;61&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="7" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Iron profile at the time of indexing &#40;January 1&#44; 2015&#41;&#46;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobin &#40;g&#47;dL&#41;&#44; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#46;1 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ferritin &#40;ng&#47;mL&#41;&#44; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">172&#46;8 &#40;31&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">241&#46;3 &#40;41&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">256&#46;0 &#40;44&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">268&#46;6 &#40;46&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Transferrin saturation index &#40;&#37;&#41;&#44; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;8 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;0 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;8 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;9 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;7 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;5 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Iron profile 3 months before starting treatment with ESAs</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobin &#40;g&#47;dL&#41;&#46; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;6 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;6 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ferritin &#40;ng&#47;mL&#41;&#44; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181&#46;8 &#40;29&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">248&#46;1 &#40;29&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Transferrin saturation index &#40;&#37;&#41;&#46; mean &#40;SD&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;9 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;0 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Demographic and clinical characteristics of patients in the prevalent population&#46; Prevalence and incidence data are provided as of January 1 of each year&#46;</p>"
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        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
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            "identificador" => "at0025"
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ESA&#58; erythropoiesis-stimulating agents&#59; CKD&#58; chronic kidney disease&#59; ND&#58; not on dialysis&#59; D&#58; on dialysis&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Prevalence and incidence data are provided as of January 1 of each year&#46; Follow-up of patients is considered for 12 months from January 1 of each year&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Prevalence in CKD patients &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence in CKD patients with anemia &#40;&#37;&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prevalence in CKD patients with anemia treated with ESAs &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Date&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">January 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3a-5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD&#40;3b&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD&#40;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">ND-CKD&#40;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hemodialysis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Peritoneal dialysis&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ESA&#58; erythropoiesis-stimulating agents&#59; CKD&#58; chronic kidney disease&#59; IV&#58; intravenous&#59; ND&#58; not on dialysis&#59; D&#58; on dialysis&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a-5&#41; with anemian&#160;&#61;&#160;20&#44;303&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3b&#41; with anemian&#160;&#61;&#160;6&#44;331&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemian&#160;&#61;&#160;315&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on hemodialysisn&#160;&#61;&#160;198&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Number and proportion of patients with each treatment regimen during the 12-month follow-up&#44; n &#40;&#37;&#41;&#46;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oral iron&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Oral iron&#46; i&#46;v&#46; and ESA&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Administration of &#62; 1 transfusion</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a-5&#41; with anemia and ESAn&#160;&#61;&#160;5&#44;413&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on hemodialysis and ESAn&#160;&#61;&#160;202&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on peritoneal dialysis and ESAn&#160;&#61;&#160;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ERI<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#40;IU week&#47;kg&#47;g of Hb in 100&#160;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;8 &#40;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;0 &#40;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;6 &#40;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;0 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;4 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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              "identificador" => "tblfn0005"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">ERI&#58; erythropoietin resistance index&#160;&#61;&#160;weekly ESA dose&#47;weight &#40;kg&#41;&#47;Hb &#40;g&#47;dl&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Erythropoietin resistance index during the follow-up period&#46;</p>"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">CKD&#44; chronic kidney disease&#59; ESA&#44; erythropoiesis-stimulating agents&#59; CKD&#44; chronic kidney disease&#59; ND&#44; not on dialysis&#59; D&#58; Dialysis&#59; SD&#44; standard deviation&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Population with anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a-5&#41; with anemian&#160;&#61;&#160;20&#44;303&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a&#41; with anemian&#160;&#61;&#160;7&#44;814&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3b&#41; with anemian&#160;&#61;&#160;6&#44;331&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;4&#41; with anemian&#160;&#61;&#160;5&#44;186&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;5&#41; with anemian&#160;&#61;&#160;972&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemian&#160;&#61;&#160;315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on hemodialysisn&#160;&#61;&#160;198&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on peritoneal dialysisn&#160;&#61;&#160;117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobin &#40;g&#47;dL&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;4 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;2 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;0 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;5 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ferritin &#40;ng&#47;mL&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">187&#46;1 &#40;35&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">176&#46;2 &#40;30&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">183&#46;6 &#40;32&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">198&#46;7 &#40;34&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">238&#46;3 &#40;42&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">254&#46;6 &#40;43&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">258&#46;1 &#40;43&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">248&#46;4 &#40;43&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transferrin saturation index &#40;&#37;&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;2 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;2 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;2 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;4 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Population with anemia treated with ESA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3a-5&#41; with anemia and ESAn&#160;&#61;&#160;5&#44;413&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3a&#41; with anemia and ESAn&#160;&#61;&#160;1&#44;408&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;3b&#41; with anemia and ESAn&#160;&#61;&#160;1&#44;897&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;4&#41; with anemia and ESAn&#160;&#61;&#160;1&#44;591&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND-CKD &#40;5&#41; with anemia and ESAn&#160;&#61;&#160;517&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-CKD with anemia on ESAn&#160;&#61;&#160;303&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-CKD with anemia in hemodialysis on ESAn&#160;&#61;&#160;202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D-CKD with anemia on peritoneal dialysis and ESAn&#160;&#61;&#160;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobin &#40;g&#47;dL&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;6 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;8 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;6 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ferritin &#40;ng&#47;mL&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">249&#46;8 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transferrin saturation index &#40;&#37;&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20&#46;3 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Descriptive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a-5&#41; with anemia and ESRD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3a&#41; with anemia and ESRD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;3b&#41; with anemia and ESRD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;4&#41; with anemia and ESA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ND-CKD &#40;5&#41; with anemia and ESA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia and ESA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on hemodialysis and ESA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D-CKD with anemia on peritoneal dialysis and ESA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="9" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">ESA treatment</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>n valid &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;378 &#40;62&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">937 &#40;66&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;241 &#40;65&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">925 &#40;58&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">104 &#40;34&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;24&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;54&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patients maintaining hemoglobin 10&#8211;12&#160;g&#47;dL<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&#46; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">292 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">98 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">122 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobin unstable<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;311 &#40;38&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">351 &#40;37&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">438 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">388 &#40;42&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">134 &#40;48&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;66&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;77&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patients with occasional rises or falls<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a> in Hb&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;775 &#40;52&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Treatment with oral iron and ESAs</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">438 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">139 &#40;26&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patients maintaining hemoglobin 10&#8722;12&#160;g&#47;dL<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">28 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unstable hemoglobin<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">517 &#40;37&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">102 &#40;32&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">178 &#40;37&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">177 &#40;40&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60 &#40;43&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;29&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patients with occasional Hb rises or falls<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a>&#46; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">739 &#40;54&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">257 &#40;54&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">233 &#40;53&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">72 &#40;51&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;72&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;100&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;70&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">I&#46;v&#46; iron treatment and ESA treatment</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>n valid &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">632 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">171 &#40;9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">209 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">103 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">173 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">146 &#40;72&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27 &#40;26&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patients maintaining hemoglobin 10&#8722;12&#160;g&#47;dL<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;9&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">3 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobin unstable<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&#44; n &#40;&#37;&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n